Techniques and materials for skin closure in caesarean section.

Area of Science:

• Obstetrics and Gynecology
• Surgical Techniques
• Wound Healing

Background:

• Caesarean section is a common surgical procedure with varied techniques for skin closure.
• Standardized methods for skin closure after caesarean section are lacking.
• A variety of materials and techniques are used, necessitating a comparison of outcomes.

Purpose of the Study:

• To compare the effects of different skin closure techniques and materials on maternal and operative outcomes following caesarean section.
• To evaluate the efficacy and safety of various skin closure methods in caesarean deliveries.

Main Methods:

• A systematic search of the Cochrane Pregnancy and Childbirth Group's Trials Register was conducted.
• Randomized controlled trials comparing different skin closure materials in caesarean sections were included.
• Data from eligible trials were independently abstracted by two review authors.

Main Results:

• Non-absorbable staples and absorbable subcutaneous sutures are the most compared methods.
• Staples and sutures showed similar incidences of wound infection and wound complications for Pfannenstiel incisions.
• Non-absorbable staples were associated with an increased risk of skin separation and reclosure compared to absorbable subcutaneous sutures.

Conclusions:

• There is insufficient conclusive evidence to recommend a specific skin closure method after caesarean section.
• Staples and sutures demonstrate comparable outcomes regarding wound infection, pain, and cosmesis.
• Early staple removal (day three) increases the incidence of skin separation and reclosure compared to absorbable sutures.